Decision-making refers to the ability to consider multiple competing alternatives and make a choice, and successful decision-making is critical for maintaining independence and well-being in society. Elderly adults are constantly faced with important decisions, as in financial and health-care matters, and recent work suggests decision-making abilities become significantly impaired with age. Age-related pathological changes in the brain are well documented, suggesting the suboptimal functioning of neural systems may be essential to impaired decision-making in elderly adults. Decision-making can be viewed as the complex interaction of two relatively distinct neural systems: a deliberative cognitive processing system involving executive functions and memory, and an affective system involving personality traits and decision styles. While neuroimaging has yielded some advances in our knowledge of the brain structures and functions involved in these systems in younger populations, relatively little is known about the neuroimaging correlates of pathological changes associated with these systems in elderly adults or how they contribute to impaired decision-making. The overall goal of the proposed Beeson Career Development Award (K23) is to identify the structural and functional neuroimaging correlates of impaired financial and health-care decision-making in non-demented older adults. This will be achieved through the completion of a focused research project which will integrate multi-level neuroimaging methods sensitive to brain structure, function, and connectivity with recent approaches to the study of decision-making; and a comprehensive training program in neuroimaging, decisionmaking, bioethics, geriatrics, neuroepidemiology, biostatistics, and leadership skill development in a highly supportive multi-disciplinary environment. Knowledge of the neural correlates of impaired decision-making behaviors in elderly adults can facilitate targeted pharmacological and behavioral interventions aimed at delaying age-related decline. Many negative financial and health outcomes may therefore be minimized through such knowledge, reducing the emotional toil and economic burden to affected patients, family members, and society. PUBLIC HEALTH RELEVANCE: The overall goal of the proposed Beeson Career Development Award (K23) is to identify the structural and functional neuroimaging correlates of impaired financial and health-care decision-making in non-demented older adults. Knowledge of the neural correlates of impaired decision-making behaviors in elderly adults can facilitate targeted pharmacological and behavioral interventions aimed at delaying age-related decline. Many negative financial and health outcomes may therefore be minimized through such knowledge, reducing the emotional toil and economic burden to affected patients, family members, and society.